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Temporal trends in stroke incidence and case-fatality rates in Arcadia, Greece: A sequential, prospective, population-based study.

Authors
  • Karantali, Eleni1, 2, 3
  • Vemmos, Konstantinos4
  • Tsampalas, Evangelos1
  • Xynos, Konstantinos1
  • Karachalia, Persefoni1
  • Lambrou, Dimitrios4
  • Angeloglou, Stella1
  • Kazakou, Maria1
  • Karagianni, Aikaterini1
  • Aravantinou-Fatorou, Konstantina1
  • Karakatsani, Eleftheria1
  • Bots, Michiel L5
  • Karamatzianni, Georgia1
  • Bellos, Stavros1
  • Ntiloudis, Romanos1
  • Lypiridou, Maria1
  • Gamvoula, Anastasia1
  • Georgiopoulos, Georgios6
  • Ajdini, Erold7
  • Gatselis, Nikolaos3
  • And 3 more
  • 1 Neurological Department, Arcadia General Hospital, Tripoli, Greece. , (Greece)
  • 2 Third Neurological Department, Aristotle University of Thessaloniki, Thessaloniki, Greece. , (Greece)
  • 3 Department of Internal Medicine, University of Thessaly, Larissa, Greece. , (Greece)
  • 4 Hellenic Stroke Organization, Athens, Greece. , (Greece)
  • 5 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. , (Netherlands)
  • 6 School of Biomedical Engineering and Imaging Sciences, King's College, London, UK.
  • 7 Department of Statistics, Athens University of Economics and Business, Athens, Greece. , (Greece)
  • 8 Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece. , (Greece)
Type
Published Article
Journal
International Journal of Stroke
Publisher
SAGE Publications
Publication Date
Jan 01, 2022
Volume
17
Issue
1
Pages
37–47
Identifiers
DOI: 10.1177/1747493021995594
PMID: 33527879
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015-2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231-239) in 1993/1995, 252 (95% CI 223-286) in 2004, and 211 (192-232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72-0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58-0.90). This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

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